CAJ | 학술논문

目的：探讨原发性肝癌TACE术后血管改变及复发转移的影响因素。方法将148例原发性肝癌出现复发转移的患者设为复发转移组。另选取同期收治的148例原发性肝癌未出现复发转移的患者设为无复发转移组。2组均采取TACE术治疗。分析2组患者临床资料之间存在的差异，以及肝外侧支循环发生率、肝动脉狭窄闭塞发生率与介入治疗次数的关系，并对影响复发转移的相关因素进行多因素Logistic回归分析。结果复发转移组患者肝外侧支循环及肝动脉狭窄闭塞的发生率均随着介入治疗次数的增多而呈不断升高的趋势。经单因素及多因素Logistic回归分析发现，肝硬化、肿瘤大小、包膜是否完整、分化程度、是否存在多结节融合等5个变量是影响原发性肝癌TACE术后复发转移的独立危险因素（ P＜0．05）。结论原发性肝癌TACE术后的复发转移与肝硬化、肿瘤大小、包膜是否完整、分化程度、是否存在多结节融合、栓塞是否彻底、侧支循环的建立及肝动脉狭窄闭塞等因素密切相关。
목적：탐토원발성간암TACE술후혈관개변급복발전이적영향인소。방법장148례원발성간암출현복발전이적환자설위복발전이조。령선취동기수치적148례원발성간암미출현복발전이적환자설위무복발전이조。2조균채취TACE술치료。분석2조환자림상자료지간존재적차이，이급간외측지순배발생솔、간동맥협착폐새발생솔여개입치료차수적관계，병대영향복발전이적상관인소진행다인소Logistic회귀분석。결과복발전이조환자간외측지순배급간동맥협착폐새적발생솔균수착개입치료차수적증다이정불단승고적추세。경단인소급다인소Logistic회귀분석발현，간경화、종류대소、포막시부완정、분화정도、시부존재다결절융합등5개변량시영향원발성간암TACE술후복발전이적독립위험인소（ P＜0．05）。결론원발성간암TACE술후적복발전이여간경화、종류대소、포막시부완정、분화정도、시부존재다결절융합、전새시부철저、측지순배적건립급간동맥협착폐새등인소밀절상관。
Objective To investigate influence factors of vascular changes and recurrence and metastasis of primary he -patic carcinoma treated with TACE .Methods 148 cases of primary liver cancer patients with recurrence and metastasis were se-lected as the recurrence group ,and 148 cases of primary liver cancer patients without recurrence and metastasis were selected as the non-recurrence group.Both groups received TACE .Clinical data,incidence of hepatic collateral vessels ,incidence of hepatic artery stenosis and occlusion and relationship with number of interventional therapy were analyzed ,and related factors for recur-rence and metastasis were analyzed by multivariate logistic regression analysis .Results The incidence of extrahepatic collateral vessels and occlusion of hepatic artery stenosis in recurrence group increased with the increase of the number of intervention .Uni-variate and multivariate logistic regression analysis showed that cirrhosis ,tumor size,capsule intact,differentiation,integration of multiple nodules were independent risk factors for postoperative recurrence and metastasis in primary liver cancer treated with TA -CE(P<0.05).Conclusion Primary liver cancer recurrence and metastasis after TACE is closely related with cirrhosis ,tumor size,capsule intact,differentiation,integration of multiple nodules ,complete embolization,establishment of collateral circulation and hepatic arterial occlusive stenosis .